招募患者:西妥昔单抗联合化疗对比单纯化疗一线治疗晚期头颈部鳞癌的疗效和安全性的III期临床试验

2015-09-09 MedSci MedSci原创

1. 试验药物简介 西妥昔单抗是针对EGF受体的IgG1单克隆抗体,两者特异性结合后,通过对与EGF受体结合的酪氨酸激酶(TK)的抑制作用,阻断细胞内信号转导途径,从而抑制癌细胞的增殖,诱导癌细胞的凋亡,减少基质金属蛋白酶和血管内皮生长因子的产生。 西妥昔单抗(爱必妥)2004年获准在美国上市,本试验的适应症是头颈部鳞状细胞癌。   2. 试验目的 评估西妥昔单抗联合顺铂加5-

1. 试验药物简介
西妥昔单抗是针对EGF受体的IgG1单克隆抗体,两者特异性结合后,通过对与EGF受体结合的酪氨酸激酶(TK)的抑制作用,阻断细胞内信号转导途径,从而抑制癌细胞的增殖,诱导癌细胞的凋亡,减少基质金属蛋白酶和血管内皮生长因子的产生。
西妥昔单抗(爱必妥)2004年获准在美国上市,本试验的适应症是头颈部鳞状细胞癌。
 
2. 试验目的
评估西妥昔单抗联合顺铂加5-氟尿嘧啶对比顺铂加5-氟尿嘧啶一线治疗中国头颈部复发性和/或转移性鳞状细胞癌受试者的疗效和安全性。
 
3. 试验设计
试验分类: 安全性和有效性
试验分期: III期
设计类型: 平行分组(试验组:西妥昔单抗+顺铂+5-氟尿嘧啶,对照组:顺铂+5-氟尿嘧啶)
随机化:  随机化
盲法: 开放
试验范围:  国内试验
入组人数:   240
 
4. 入选标准
1   年龄≥18岁
2   经组织学或细胞学确认诊断的头颈部鳞状细胞癌(SCCHN)
3   不适合接受局部区域治疗的复发和/或转移性SCCHN
4   至少具有一个根据RECIST版本1.1判断为可测量的病灶
5   在进行任何试验相关活动之前签署书面知情同意书
6   ECOG体能状态为0分或1分
7   中性粒细胞≥1.5x10的9次方/L,血小板计数≥100x10的9次方/L和血红蛋白≥90 g/L
8   总胆红素≤2x正常范围上限(ULN);天门冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)≤3xULN(如果发生肝转移,ALT和AST≤5xULN)
9   纠正后的校正血清钙、血钾和血镁值在正常范围之内(允许在筛选期间纠正电解质)
10 24小时肌酐清除率≥60 mL/分
11 如果具有生育能力(既适用于男性也适用于女性受试者),采取有效的避孕措施,直到最后一剂试验治疗后至少3个月
 
5. 排除标准
1   接受过系统化疗,但不包括作为多模式治疗的一个环节针对局部晚期疾病进行的化疗(此项治疗必须距试验开始完成超过6个月)
2   进入试验之前4周之内接受过手术(不包括既往诊断性活检)或放射治疗
3   既往接受过以EGFR为靶点的单克隆抗体或信号转导抑制剂治疗
4   鼻咽癌
5   已知对于本试验治疗的任何成分会产生过敏反应
6   活动性感染,包括活动性结核、已知和确证的人免疫缺陷病毒(HIV)感染或引起肝功能损害或硬化的活动性乙型/丙型肝炎病毒感染(HBV/HCV)
7   器官同种移植、自体/异体干细胞移植和肾脏替代治疗史
8   无症状性重度高血压高血压危象,定义为静息状态收缩压≥180 mmHg和/或舒张压≥110 mmHg
9   心脏功能损害,表现为任何下列状况:左心室射血分数<45%;严重心律失常;不稳定性心绞痛;纽约心脏协会III或IV级充血性心力衰竭;进入试验之前近12个月之内发生过心肌梗塞;心包积液。
10 已知发生了中枢神经系统转移和/或软脑膜疾病。有神经科症状的受试者应接受一次脑部CT/MRI检查以排除脑转移。
11 已知未得到控制的糖尿病、肺纤维化、间质性肺病、急性肺病或肝衰竭。
12 ≥2级外周神经疾病或听力丧失
13 未从既往手术、化疗或放疗的任何急性影响中恢复,即未降至≤1级(CTCAE,版本4.03)的受试者。如果营养状态稳定,允许既往放疗和/或手术产生的慢性晚期毒性(咽/喉毒性,即口腔干燥,言语、吞咽异常等)。
14 已知酒精和/或药物滥用
15 会妨碍受试者完成试验或签署知情同意书的医学或心理状况
16 具有SCCHN以外肿瘤的病史或现病史,不包括经根治性治疗的非黑色素皮肤癌、原位宫颈癌,或者其他经过根治性治疗且至少5年无疾病迹象的癌症。
17 进入试验之前30天之内接受过任何研究药物
18 孕妇(未经血清β-人绒毛膜促性腺激素[HCG]试验确认)或哺乳期女性受试者,或者具有生育能力而不愿或不能够采用一种高效节育/避孕方法以防止在接受试验治疗之前2周到接受最后一剂试验治疗之后3个月期间发生妊娠的男性和女性。高效避孕方法定义为坚持正确使用时失败率较低(每年<1%)的避孕方法。
19 同时接受一种方案规定的禁用药物治疗
20 具有任何研究者判定可能会损害本试验开展的并存的医学情况或疾病的受试者
21 无法律行为能力/限制行为能力

6. 医院信息

序号

机构名称

主要研究者

国家

省(州)

城市

1

广州中山大学附属肿瘤医院

林桐榆

中国

广东

广州

2

复旦大学附属肿瘤医院

郭晔

中国

上海

上海

3

中国医学科学院肿瘤医院

何小慧

中国

北京

北京

4

四川大学华西医院

李平

中国

四川

成都

5

河南省肿瘤医院

刘艳艳

中国

河南

郑州

6

河南省肿瘤医院

王建华

中国

河南

郑州

7

吉林省肿瘤医院

程颖

中国

吉林

长春

8

湖南省肿瘤医院

罗以

中国

湖南

长沙

9

天津肿瘤医院

于洋

中国

天津

天津

10

浙江省肿瘤医院

葛明华

中国

浙江

杭州

11

哈尔滨医科大学附属肿瘤医院

张清媛

中国

黑龙江

哈尔滨

12

辽宁省肿瘤医院

李振东

中国

辽宁

沈阳

13

海南省人民医院

陈岩菊

中国

海南

海口

14

海南省人民医院

王琳

中国

海南

海口

15

第三军医大学第三附属医院(大坪医院)

王东

中国

重庆

重庆

16

中南大学湘雅医院

申良方

中国

湖南

长沙

17

广东省人民医院

郑登云

中国

广东

广州

18

中山大学孙逸仙纪念医院

黄晓明

中国

广东

广州

19

北京大学肿瘤医院

孙艳

中国

北京

北京

20

临沂市肿瘤医院

石建华

中国

山东

临沂

21

广州医科大学附属肿瘤医院

李卫东

中国

广东

广州

22

江苏省肿瘤医院

冯继锋

中国

江苏

南京

23

南方医科大学南方医院

廖旺军

中国

广东

广州

24

华中科技大学同济医学院附属同济医院

于世英

中国

湖北

武汉

25

广西医科大学附属肿瘤医院

朱小东

中国

广西

南宁

26

南昌大学第二附属医院

刘安文

中国

江西

南昌

27

重庆医科大学附属第一医院

陈晓品

中国

重庆

重庆

28

华中科技大学同济医学院附属协和医院

杨坤禹

中国

湖北

武汉

29

四川省肿瘤医院

郞锦义

中国

四川

成都

30

江西省肿瘤医院

陈颖兰

中国

江西

南昌

31

云南省肿瘤医院

沈丽达

中国

云南

昆明

32

北京协和医院

白春梅

中国

北京

北京

33

上海交通大学附属第九人民医院

朱国培

中国

上海

上海

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encryptionId=53961018913, topicName=I期临床试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45b2276, createdName=839640778, createdTime=Wed Jul 27 00:18:00 CST 2016, time=2016-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652738, encodeId=c0891652e3844, content=<a href='/topic/show?id=5b011018e07' target=_blank style='color:#2F92EE;'>#I期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10187, encryptionId=5b011018e07, topicName=I期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fc1f24335670, createdName=医生2402, createdTime=Mon Feb 15 23:18:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411708, encodeId=34f31411e086e, content=<a href='/topic/show?id=a53e806837f' target=_blank style='color:#2F92EE;'>#联合化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80683, encryptionId=a53e806837f, topicName=联合化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ebf32807001, createdName=oliver170, createdTime=Fri Sep 11 13:18:00 CST 2015, time=2015-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484618, encodeId=be741484618f3, content=<a href='/topic/show?id=3502102944e7' target=_blank style='color:#2F92EE;'>#鳞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102944, encryptionId=3502102944e7, topicName=鳞癌)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20171006/a73877485ccdf6add82293e671bebe21.jpg, createdBy=745a7977375, createdName=1696533704_45270456, createdTime=Fri Sep 11 13:18:00 CST 2015, time=2015-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491765, encodeId=d4531491e65c3, content=<a href='/topic/show?id=b4f14442346' target=_blank style='color:#2F92EE;'>#头颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44423, encryptionId=b4f14442346, topicName=头颈部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Fri Sep 11 13:18:00 CST 2015, time=2015-09-11, status=1, ipAttribution=)]
    2016-01-29 chengjn
  3. 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  4. 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  5. 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    2016-01-12 huangshang9812

    我们天津省肿瘤医院

    0

  6. 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  7. 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